Video Gallery

Video Gallery

To View the Video

Chronic Abductor Tendon Tear Reconstruction via a Dermal Allograft

March 01, 2019

Contributors: Guillem Gonzalez-Lomas, MD; Dylan Lowe, MD; Utkarsh Anil, BA; Utkarsh Anil, BA

The abductor mechanism around the hip, specifically the gluteus medius and minimus muscle-tendon complex, is essential for gait and hip joint stability. Patients with abductor mechanism deficiency most commonly have severe pain over the lateral aspect of the hip, a limp with a Trendelenburg gait, and a feeling of instability around the hip joint. In general, patients with hip abductor deficiency have a painful degenerative or traumatic tear, an asymptomatic tear that is identified during a surgical procedure such as hip arthroplasty, or an iatrogenic tear sustained during hip arthroplasty. In patients with an abductor tendon tear, treatment begins with formal physical therapy and injections. For patients in whom nonsurgical treatment fails and patients with symptoms, treatment consists of surgical techniques such as open or endoscopic primary abductor tendon repair, gluteus maximus tendon transfer, and abductor complex reconstruction via allograft tissue. Abductor tendon reconstruction with the use of Achilles tendon and dermal allografts has been described in the literature. This video demonstrates chronic abductor tendon tear reconstruction via a dermal allograft. The video provides an overview of the demographics and etiologies of abductor tendon deficiency followed by the case presentation of a 79-year-old woman with a chronic abductor tendon tear. The patient experienced persistent lateral hip pain while walking for 3 to 4 weeks prior to presentation and did not have a history of recent trauma. She was unable to sleep on the affected side and had a substantial gait abnormality. Radiographs of the pelvis revealed mild osteoarthritis and productive changes at the level of the greater trochanter, which suggested a chronic degenerative process. MRI revealed a full-thickness abductor mechanism tear, with the gluteus medius and minimus tendons avulsed and retracted from their footprint on the greater trochanter and minimal fatty atrophy. Abductor tendon reconstruction via a dermal allograft was performed. Excellent restoration of function and resolution of pain were achieved. Abductor tendon complex reconstruction is a reliable treatment option for patients with a chronic abductor tendon tear. Smaller case series have demonstrated substantial improvements in pain, limp and gait, and hip abduction strength in patients who undergo abductor tendon complex reconstruction via a dermal allograft.

Results for "Sports Medicine"

1 of 26
1 of 26

X